EUS-guided Intra-tumour Injection of OncoSil for Locally Advanced Pancreatic Carcinoma.

Pancreatic Cancer Clinical Trial

Official title:

Concurrent EUS-guided Intra-tumour Injection of OncoSil (32P) With Chemotherapy in Locally Advanced Pancreatic Carcinoma.

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05131776
• Other study ID #: NTEC-2021-0234
• Status: Recruiting
• Phase: Phase 2/Phase 3
• Start date: November 1, 2021
• Est. completion date: October 31, 2024

Study information

• Verified date: February 2023
• Source: Chinese University of Hong Kong
• Contact: Anthony YB Teoh, FRCSEd
• Phone: 35052956
• Email: anthonyteoh[@]surgery.cuhk.edu.hk
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The outcomes of concurrent EUS-guided intra-tumour injection of P-32 microparticles (OncoSil; OncoSil Medical, Australia) with chemotherapy in locally advanced pancreatic carcinoma in the local population is uncertain. The aim of the current study is to assess efficacy and safety of the intervention in the local population. We hypothesis that the intervention is safe and useful for tumour downstaging.

Description:

This would be a cohort study including patients with locally advanced pancreatic cancer medically fit to receive chemotherapy. Eligible patients would receive gemcitabine (GNP; 28- day cycles). P-32 microparticles (OncoSil; OncoSil Medical) implantation will be planned at weeks 4-5. P-32 activity will be calculated from patients' tumor volume (TV) to deliver 100 Gy absorbed dose, with implantation assessment by EUS and Bremsstrahlung SPECT/CT imaging. The primary endpoint was safety and tolerability, graded using CTCAE v4.0. Response will be assessed using RECIST 1.1 with 8-weekly CT scans and FDG-PET scans at baseline and week 12. The outcome parameters include adverse events, response of the tumour, local progression free survival and overall survival (OS).

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 20
• Est. completion date: October 31, 2024
• Est. primary completion date: October 31, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

1. Study participants are = 18 years of age at screening.

2. Histologically or cytologically proven adenocarcinoma of the pancreas.

3. Unresectable locally advanced pancreatic carcinoma. Patients with technically resectable tumours (T1-T3) will also be eligible, if they are deemed unresectable due to medical comorbidities or refusal of surgery.

4. Pancreatic target tumour diameter = 2.0 cm (shortest axis) to = 6.0 cm (longest axis)

5. An ECOG Performance Status of 0 to 1 and Karnofsky Performance Status of 80 - 100.

6. Willing and able to complete study procedures within the study timelines.

7. Adequate renal function: serum creatinine less than 1.5 x upper limit of normal (ULN).

8. Adequate liver function: Serum SGOT/AST and serum SGPT/SLT < 3 times ULN and serum bilirubin <1.5 times the ULN unless the patient is known to have prior Gilbert's Syndrome.

9. Adequate bone marrow function: white blood cells (WBCs) = 3,000/mm3, absolute neutrophil count (ANC) = 1,500/mm3, haemoglobin = 9 g/dL, and platelets = 100,000/mm3.

10. Life expectancy of at least 3 months at the time of screening as judged by the investigator.

11. Not pregnant, and if of childbearing potential, agrees to use adequate birth control (hormonal or barrier method of birth control or abstinence) prior to study entry and during the study and agrees not to donate sperm or ova, for the duration of the study and 12 months post implantation of the investigational device.

12. Provide signed Informed Consent.

13. Technically feasible - tumour must be within reach of the EUS probe for fine needle Injection.

Exclusion Criteria:

1. More than one primary lesion.

2. Any prior radiotherapy or chemotherapy for pancreatic cancer.

3. Use of other investigational agent at the time of screening, or within 30 days or five half-lives of Screening Visit 1, whichever is longer.

4. History of malignancy, treated or untreated, within the past five years whether or not there is evidence of local recurrence or metastases, with the exception of basal cell carcinoma of the skin and cervical carcinoma in situ.

5. Evidence of tumour invasion into stomach, duodenum or peritoneum

6. In the opinion of the investigator, EUS directed implantation posing undue study

participant risk. This includes:

1. Where previous EUS-FNA was considered technically too difficult to perform;

2. Imaging demonstrates multiple collateral vessels surrounding or adjacent to the target tumour within the pancreas;

3. Presence (or significant risk) of varices near to the target tumour.

7. A known allergy or history of hypersensitivity to silicon, Phosphorus or any of the OncoSil™ components.

8. Patients who do not consent to chemotherapy

9. Actively on medication that increase bleeding risk (i.e. aspirin, clopidogrel, warfarin, NOAC).

10. Any other health condition that would preclude participation in the study in the judgment of the investigator.

Related Conditions & MeSH terms

• Endoscopic Ultrasound
• Pancreatic Cancer
• Pancreatic Neoplasms

Intervention

Device:
• EUS-guided oncosil injection
All patients will receive OncoSilTM during the 4th week of the first chemotherapy cycle.

Locations

Country	Name	City	State
Hong Kong	Department of Surgery, Prince of Wales Hospital	Hong Kong

Sponsors (1)

Lead Sponsor	Collaborator
Chinese University of Hong Kong

Country where clinical trial is conducted

Hong Kong, 

References & Publications (1)

Rosemurgy A, Luzardo G, Cooper J, Bowers C, Zervos E, Bloomston M, Al-Saadi S, Carroll R, Chheda H, Carey L, Goldin S, Grundy S, Kudryk B, Zwiebel B, Black T, Briggs J, Chervenick P. 32P as an adjunct to standard therapy for locally advanced unresectable — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Adverse events	Any untoward medical occurrence, unintended disease or injury, oruntoward clinical signs (including abnormal laboratory findings) in subjects, users or other persons, whether or not related to the investigational medical device	30 day
Secondary	Overall survival	Overall survival of the patient	5 years
Secondary	Local Disease Control Rate	proportion of study participants whose local tumour response is stable disease (SD), partial response (PR), or complete response (CR)	16 week
Secondary	Local Progression Free Survival	the time from enrolment to the date of the radiological scan used to determine local tumour progression or date of death, whichever comes first.	6 months
Secondary	Progression Free Survival	the time from enrolment to the date of tumour progression or of recurrence (in case of complete response (CR))	5 years